Provider Demographics
NPI:1063415578
Name:HIRSCH, JOSHUA JALOMA (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JALOMA
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOSHUA
Other - Middle Name:JALOMA
Other - Last Name:JOAQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:45 KNIGHT ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:JAFFREY
Mailing Address - State:NH
Mailing Address - Zip Code:03452-5835
Mailing Address - Country:US
Mailing Address - Phone:603-532-5629
Mailing Address - Fax:603-652-3368
Practice Address - Street 1:45 KNIGHT ST
Practice Address - Street 2:SUITE 8
Practice Address - City:JAFFREY
Practice Address - State:NH
Practice Address - Zip Code:03452-5835
Practice Address - Country:US
Practice Address - Phone:603-532-5629
Practice Address - Fax:603-652-3368
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-30
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH206-0495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U5655Medicare UPIN